Interview with John Edgar, 15 June 2010

John Edgar is Assistant Headteacher at The Dean School in Essex. He discusses his own schooling in Essex in the 1970s and his decision to become a history teacher. He recalls teaching a traditional syllabus of British history in the early 1980s, but also introducing some of the new source-based approaches. GCSE brought attention to empathy in history, which was already popular in the lower school. He left teaching to work in publishing from 1988-91 and joined a large Kent City Technology College as head of humanities at the time of the introduction of the National Curriculum. He discusses the challenges of integrating history, geography and RE. He also discusses the impact of technology on history teaching in the 1990s. Interviewed by Nicola Sheldon

Interview with Kenneth Baker, 22 October 2009

Lord Baker of Dorking was Secretary of State for Education and Science from May 1986 until July 1989. He was responsible for the 1988 Education Reform Act which introduced,for the first time, a National Curriculum in England and Wales. He set up a series of working groups to devise the new school curriculum. He discusses the reasons for introducing a national curriculum and his expectations of the History Working Group. His preference was for an overarching 'timeline' in the history curriculum. He reflects on the benefits which have resulted from the National Curriculum, but regrets that history was not made compulsory between the ages of 14 and 16, as he has initially intended. Interviewed by Nicola Sheldon

Interview with Estelle Morris, 19 October 2009

Baroness Morris of Yardley was Secretary of State for Education from June 2001 until October 2002. She was also Schools Minister under David Blunkett (interview on this website). She recalls her own experience of being taught history and of teaching it as part of 'social studies' in the 1970s. Estelle Morris discusses the reasons why history might be losing out to other subjects, such as citizenship or media studies and the reasons why history should be optional after age 14. She agrees that history is important for national identity although it should reflect the diversity of modern Britain. Interviewed by Nicola Sheldon

Interview with Evelyn Hinde, 25 January 2010

Evelyn Hinde spent her teaching career in secondary modern schools in London and Kent. She trained to teach at Stockwell Training College in 1955 where she recalls an inspiring and lively lecturer. She taught first in a girls' school in Deptford, where the four-year curriculum ranged from the Stone Age to the present day. Most students left at 15 without taking exams. Although 'chalk and talk' predominated, Evelyn collected postcards and illustrations to accompany the most dramatic historical stories and organised visits to historical sites. In the sixties, she taught in Kent schools, saw the rise of CSEs and 'integrated humanities' and the impact of TV. From 1976-96, Evelyn Hinde was a headteacher, although she continued teaching some history. Interviewed by Nicola Sheldon

Interview with Linda Turner and Rob Snow, 1 July 2010

Linda Turner and Rob Snow are history teachers working at King James School in Knaresborough, North Yorkshire. They both reflect on the deficiencies of their teacher training. Linda recalls her early career in a secondary modern in Buckinghamshire in the mid-1970s. Here she worked with an 'inspirational' head of department who engaged the students through local history. Rob by contrast recalls the challenge of moving to a multi-cultural school in Bradford where each teacher had to sort out their own curriculum. Rob and Linda talk about the changes in the teaching of history over their careers - the impact of GCSE, the National Curriculum, of technology and of the lack of time to do 'fun' things, such as the 'trip around Rome' in the school quad, with chariot races on hobby horses and mock gladiator fights, or the Arkwright song competition, which involved the singing of the songs as well as the writing of them! Interviewed by Nicola Sheldon

Arctic Ocean boundary exchanges: A review

The Arctic Ocean has long been—and to a large extent remains—a data-​sparse region. Paucity of ocean and atmosphere measurements impacts the fidelity of atmospheric reanalyses, and ungauged rivers lead to uncertainties in measurement-​based estimates of river runoff. However, there exists a data resource that can provide material help: sustained (long-term) ice and ocean measurements around the Arctic Ocean boundary. The Arctic Ocean is surrounded by land and connects to adjacent ocean basins via four main gateways: to the Pacific through Bering Strait, to the Atlantic through Davis Strait, and to the Nordic Seas via Fram Strait and the Barents Sea Opening. In addition, the Nordic Seas connect to the Atlantic across the Greenland-Iceland-Scotland Ridge, which has a substantial measurement history. Inverse methods combine these data sets to generate conservative velocity fields that are then used to generate estimates of surface fluxes of heat and freshwater as well as other quantities of interest, including net biogeochemical fluxes and (with other methods) estimates of ocean water transformation rates. Data resources are available to greatly extend the duration and the temporal resolution of present analyses

Personalized risk stratification through attribute matching for clinical decision making in clinical conditions with aspecific symptoms: the example of syncope

Background Risk stratification is challenging in conditions, such as chest pain, shortness of breath and syncope, which can be the manifestation of many possible underlying diseases. In these cases, decision tools are unlikely to accurately identify all the different adverse events related to the possible etiologies. Attribute matching is a prediction method that matches an individual patient to a group of previously observed patients with identical characteristics and known outcome. We used syncope as a paradigm of clinical conditions presenting with aspecific symptoms to test the attribute matching method for the prediction of the personalized risk of adverse events. Methods We selected the 8 predictor variables common to the individual-patient dataset of 5 prospective emergency department studies enrolling 3388 syncope patients. We calculated all possible combinations and the number of patients in each combination. We compared the predictive accuracy of attribute matching and logistic regression. We then classified ten random patients according to clinical judgment and attribute matching. Results Attribute matching provided 253 of the 384 possible combinations in the dataset. Twelve (4.7%), 35 (13.8%), 50 (19.8%) and 160 (63.2%) combinations had a match size 6550, 6530, 6520 and <10 patients, respectively. The AUC for the attribute matching and the multivariate model were 0.59 and 0.74, respectively. Conclusions Attribute matching is a promising tool for personalized and flexible risk prediction. Large databases will need to be used in future studies to test and apply the method in different conditions

A pragmatic cluster randomised trial evaluating three implementation interventions

Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients' experiences, and stakeholders' experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions' impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (POISE

FIRE (facilitating implementation of research evidence) : a study protocol

Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids